Diuretics

Question 1

Name an Osmotic Diuretic

Answer 1

Mannitol - IV

Question 2

Where do Osmotic Diuretics work

Answer 2

inhibit water reabsorption throughout the tubule (most = PCT). Increases urine volume

Question 3

3 Uses for Mannitol

Answer 3

Osmotic diuretic - decrease IOP in narrow/acute glaucoma;
Dec intracerebral pressure;
Rhabdomyolysis

Question 4

Mannitol SE

Answer 4

Osmotic diuretic - acute hypovolemia

Question 5

Carbonic Anhydrase inhibitors MOA and location

Answer 5

PCT: dec H+ formaiton in PCT cell therefore dec Na/H antiport. Inc Na and HCO3- in the lumen –> inc diuresis

Question 6

Name 2 Carbonic anhydrase inhibitors

Answer 6

Acetazolamide and dorzolamide

Question 7

3 uses for acetazolamide and dorzolamide

Answer 7

CA inhibitors: Glaucoma; acute mountain sickness; Metabolic alkalosis

Question 8

7 SE of acetazolamide

Answer 8

Bicarbonaturia and ACIDOSIS (loss of bicarb);
HYPOKALEMIA,
Hyperchloremia;
Paresthesias;
Renal stones;
Sulfonamide Hypersensitivity

Question 9

Loop Diuretics: location of action

Answer 9

Thich ascending loop - on teh NKCC pump

Question 10

Name 2 loop diuretics

Answer 10

Ethacrynic acid and furosemide

Question 11

7 uses for furosemide or ethacrynic acid

Answer 11

Loop diuretics: DOC for ACUTE PULMONARY EDEMA;
Heart failure;
HTN; Refractory edema; Acute renal failure; Anion overdose; Hypercalcemic states

Question 12

7 Side effects of furosemide and ethacryinc acid

Answer 12

Loop diuretics:
Sulfonamide hypersensitivity (furosemide)
HYPOKALEMIA;
ALKALOSIS;
HYPOALCEMIA;
HYPERURICEMIA —> warning with gout
Ototoxicity (ethacryinic - irreversibe. furosemid reversible);

Question 13

3 drug interactions to know with loop diuretics

Answer 13

Aminoglycosides (Gentamycin) enhaced ototoxicity;
Lithium (decreased clearance);
Digoxin (also gives HYPOkalemia) - increased toxicity due to electorlyte disturbances

Question 14

Where to Thiazide diuretics work

Answer 14

DCT on the Na/Cl transporter - inhibiting it increasing luminal Na and Cl

Question 15

Name 3 Thiazide diuretics

Answer 15

Hydrochlorothiazide; indapamide; Metolazone

Question 16

4 Uses of Hydrochlorothiazide, Indapamide

Answer 16

Thiazide diuretics HTN;
CHF;
Nephrolithiasis (Ca stones);
Nephrogenic diabetes insipidus

Question 17

7 SE of Hydrochlorothiazide, Indapamide

Answer 17

Sulfonamide Hypersensitivity;        
HYPOkalemia and alkalosis;           
HYPERcalcemia *;     
HYPERuricemia;         
HYPERglycemia; Hyperlipidemia

Question 18

Drug interaction and caution with thiazide diuretics

Answer 18

Digoxin - increased toxicity due to electrolyte disturbance;
Avoid in patients with diabetes mellitus